Mad, sectioned and black
Today I happened upon a piece he has written with Robert Drummond, a psychiatrist. It looks at the phenomenon of black (mostly) men being incarcerated under Section 3 of the Mental Health Act. I dropped him a line as it is a subject which has long fascinated me. Black people in this country, he tells me, are 9 times more likely to be psychotic, whilst south Asian migrants are only twice as likely.
My friend (who has just come out of hospital) is black. The first time I visited him in a secure psychiatric unit, many years ago, I thought it was a ward for black people. It wasn’t.
Every hospital and ward he has stayed in since has been the same. It is a situation that most of us are utterly unaware of, something rarely mentioned in the media, a subject which is tricky and sensitive but needs to be known.
In his article Alex ponders over the reasons, all of which have crossed my mind as I struggled with this troubling statistic.
“No one really understands why. Schizophrenic symptoms occur in all ethnic groups. The competing explanations, biological or social, of why some groups experience higher rates are fraught with tension. Perhaps the close family networks of south Asian immigrant groups act as stabilisers in an isolating city, while the more fragmentary family circumstances of Afro-Caribbeans have the reverse effect. Some argue that such findings reveal an inability among researchers to understand black culture; some that a prevalence of cannabis use plays a part in shaping Afro-Caribbean psychosis; others that racism either causes the disorder, or causes white psychiatrists to over-diagnose black patients.”
He goes on to say that schizo-affective disorder is “sometimes nicknamed the "Brixton psychosis," because the combination of schizophrenic delusions with mania appears more commonly among Afro-Caribbean patients. Research shows differing rates of mental illness among different ethnic and migrant groups, with the black population suffering less from anxiety disorders but significantly more from psychosis.”
So why is this happening in our communities? Are the causes social, genetic or racial? Is it that black people are more likely to live in poverty and battle the stresses and strains that this brings? Well plenty of white people do too. Is it the trauma caused by racial taunting and prejudice which brings it on? But Asian’s are as likely (if not more, in this day and age) to experience that too. If either of these were the cause, it seems strange then that Afro-Caribbean’s are less likely to suffer from anxiety disorders, a common reaction to an over stressed life.
Is there something in their genetic make up which means they are more predisposed to psychotic illnesses? Or is it simply that a (and most of them are) white doctor is more likely to section a mad black man, through prejudice or ignorance, than the less threatening (to him) mad white man?
Alex talks in his piece about a young man, named Victor whose “basic problem was his reluctance to stick to his medication”. This was true of my friend, and so many others. Is there a stronger feeling of pride amongst young black men? A machismo which prevents them from admitting that they are ill? Lack of insight is a hard nut to crack (it has taken 3 years of weekly sessions for my friend’s psychiatrist to get there), is it more prevalent amongst black sufferers of mental illness?
“Section 3 of the Mental Health Act is perhaps the most authoritarian piece of legislation in the British statute book. It allows doctors to lock up a patient for compulsory treatment for far longer than anti-terror legislation can hold a prisoner without charge.” There is uproar and outrage amongst human rights groups and the black community at the disproportionate number of black youths who are stopped and searched. No one out there, seems to be up in arms about the same situation in our mental health hospitals.
Is it too much for the media to bear? Two taboo and sensitive subjects wrapped up in one. It’s bad enough being black (if you are the Mail) even worse if you are mad, but God help you if you’re unlucky enough to be both.